Ina May’s acolytes spew misinformation far and wide

The great irony of the natural childbirth and homebirth movements is that advocates think they are “educated.” As I have said many times in the past, most of what these women think they “know” is factually false. That’s because all their information comes from celebrity natural childbirth and homebirth advocates who misinterpret, misrepresent or flat out fabricate their “facts.”

Recent examples include Henci Goer thoroughly misrepresenting the Friedman Curve while simultaneously illustrating her lack of knowledge of the most basic statistical concepts (Anatomy of a natural childbirth smear), Amy Romano demonstrating a total lack of understanding of both pelvic trauma and basic research (How Lamaze promotes misinformation), and Rixa Freeze, gleefully transmitting what was obviously false information without bothering to source it or check its accuracy (Birth of a natural childbirth lie). But when it comes to misinformation, no one can hold a candle to self proclaimed midwife Ina May Gaskin. Ina May just makes it up as she goes along.

No one in their right mind ought to expect scientific accuracy from a woman who declares (In Spiritual Midwifery):

… Pregnant and birthing mothers are elemental forces, in the same sense that gravity, thunderstorms, earthquakes, and hurricanes are elemental forces. In order to understand the laws of their energy flow, you have to love and respect them for their magnificence at the same time that you study them with the accuracy of a true scientist.

The invocation of mysterious forces, “energy flow” and intentional biologic processes marks her as a garden variety quack. Yet natural childbirth and homebirth advocates continue to believe her anyway.

An article in today’s Guardian, I was pregnant for 10 months, by Viv Groskop, is typical of the junk that emanates from Ina May, and broadcast far and wide. The author of the article went 20 days postdates before giving in to her doctor’s plea to be induced. The author is proud that her baby did not die, and thinks this means something. Of course that’s like refusing to belt your child into the car and then declaring proudly that the baby survived the trip to the grocery store intact. It demonstrates the classic NCB ignorance of relative risk. In their minds, every risk is either 0% or 100%. So if their child survives their foolishness, they think they have “proven” that the risk does not exist.

Having failed to kill her own baby, the author wonders whether induction for postdates is unnecessary.

The US midwifery guru Ina May Gaskin thinks so. She believes that every baby will come in its own time, and she is currently campaigning for 43 weeks – rather than 42 – as the definition of “late”. The dates in themselves, says Gaskin, do not indicate the need for induction.

Ina May’s claim reflects both a lack of basic knowledge (why 40 weeks is considered the standard length of pregnancy) and a touching though deadly naivete that insists that changing the definition of a phenomenon will change its outcome.

The author invokes Ina May’s arguments (all false) for changing the definition of postdates:

Naegle’s rule on length of pregnancy dates back to the 1800’s.
We lack evidence on what happens after 42 weeks since few women go beyond.
The claim that stillbirth risk doubles is based on data from 1958.

Ina May and her acolytes clearly don’t bother with the scientific literature. If they did, they would know that the US looks at the data each and every year and publishes an elaborate (and free) analysis of it. The most recent analysis comes from 2005, not 1958. It’s entitled Fetal and perinatal mortality, United States, 2005 by MacDorman et al.

It contains two rather compelling graphs. The first plots stillbirths against gestational age.

As you can see, the stillbirth rate actually begins to rise at 36 weeks. At that point, the risks associated with early delivery outweigh the risk of stillbirth. The stillbirth rate continues to rise after 40 weeks, and begins to rise precipitously even before 42 weeks. So much for the claim that the current recommendations are based on data that is more than 50 years old.

Ina May’s accolyte complains that the induction rate has been rising each and every year. That’s true in the UK and that’s true in the US. But look what has happened during the same period of time.

The graph shows that the stillbirth rate has dropped each and every year, but not all stillbirths, only late stillbirths.

The fetal mortality rate for 28 weeks of gestation or more declined by 29% from 1990–2003, but did not decline significantly from 2003–2005. In contrast, the fetal mortality rate for 20–27 weeks of gestation has changed little since 1990. Thus, nearly all the decline in fetal mortality from 1990 to 2003 was among fetal deaths of 28 weeks of gestation or more.

The increased rate of induction has been accompanied by a decrease in late stillbirths. This is the reason why inductions are recommended. They successfully do what they are intended to do.

The piece in the Guardian is a classic of natural childbirth advocacy. A layperson cheerfully transmits absolute garbage from a celebrity natural childbirth advocate who made it all up. That’s what happens when “educated” natural childbirth advocates “educate” each other.